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INVESTIGATIVE REPORT
Delusional Infestation: Perspectives from Scottish Dermatologists
and a 10-year Case Series from a Single Centre
Yee Ling WONG 1 , Andrew AFFLECK 1 and Alexander M. STEWART 2
Departments of 1 Dermatology, and 2 Psychiatry, Ninewells Hospital, NHS Tayside, Dundee, United Kingdom
Perceptions of the clinical management of delusional
infestation (DI) were compared with clinical outco-
mes in this 10-year case series from a single centre in
Dundee, UK. An online questionnaire (survey-monkey,
a TM brand of online survey available for free for ba-
sic use) was sent to Scottish Dermatologists to gauge
their opinions and confidence in the management of
DI. Also, a retrospective review of medical case notes
of patients seen by dermatologists in one institution
was undertaken and clinical outcomes were repor-
ted by patients’ general practitioners (GP). The sur-
vey showed that 61% of responding dermatologists
encountered 1–5 cases of DI per year. Twenty-four
percent respondees were ‘confident’ in managing pa-
tients with DI, 54% were ‘somewhat confident’. Forty-
seven patients (62% female, 70% single) were seen
over the 10 years; 43% brought a self-collected spe-
cimen to clinic, 68% of patients had a psychiatric co-
morbidity, 23% of patients had primary DI and 11/47
(23%) were seen by a psychiatrist. Clinical outcomes
as rated by patients’ GPs were reasonable or good in
2/3 patients. A poor outcome was seen in 12 patients
and associated with chronic pain in 50% (p < 0.01) and
psychiatric comorbidity in 100% (p < 0.01). We con-
clude that good outcomes can be achieved in some pa-
tients with DI without psychiatric input and without
psychoactive treatment.
Key words: delusional; infestation; parasitosis; psychoderma
tology.
Accepted Dec 20, 2017; Epub ahead of print Dec 21, 2017
Acta Derm Venereol 2018; 98: 441–445.
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